Flexible tissue removal devices and methods

• US 9,351,741 B2
• Filed: 11/15/2013
• Issued: 05/31/2016
• Est. Priority Date: 05/04/2006
• Status: Active Grant

• Current Assignee: Spinal Elements, Inc.
• Original Assignee: Amendia, Inc. (Spinal Elements, Inc.)
• Inventors: Schmitz, Gregory P., Bleich, Jeffery L., Spisak, Steven A., Leguidleguid, Roy, Bleam, Jefferey
• Primary Examiner(s): BATES, DAVID W
• Application Number:
  US14/082,052
• Publication Number:
  US 20140074097A1
• Time in Patent Office: 928 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/149 Chain, wire or band saws
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/320004 abrasive
• CPC Class Codes: A61B 2017/32006 with a cutting strip, band or chain, e.g. like a chainsaw
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2090/08021 of the patient or his organs

Abstract

A device for removing tissue from a patient may include an elongate flexible body having a proximal end, a distal end, and a longitudinal axis therebetween, the elongate body having opposed first and second major surfaces with a lateral orientation across the axis, and a plurality of blades distributed laterally across the first major surface. Each blade may have a first end adjacent the first surface and extending to a cantilevered second end, a first edge between the first and second ends of the blade being oriented toward the distal end of the elongate body, a second edge between the first and second ends of the blade being oriented toward the proximal end of the elongate body, a height of the blade between its first and second ends, and an axial length of the blade between its first and second edges.

Claims

1. A method for modifying a target bone of a bone joint in a patient, the method comprising:

advancing a guidewire into the body and adjacent to the target bone of a bone joint so that the guidewire passes along a path through the patient where the proximal end of the guidewire extends from a first position outside of the patient'"'"'s body and the distal end of the guidewire extends from a second position outside of the patient;

coupling the proximal end of the guidewire to a tissue modification device outside of the body after advancing the guidewire into the body, wherein the tissue modification device is for modifying bone tissue and comprises an elongate flexible body having a tissue-modifying active region;

pulling the tissue modification device behind the guidewire along the path to position the active region of the tissue modification device adjacent to the target bone of the bone joint, wherein the proximal end of the guidewire remains within the body;

urging the active region of the tissue modification device against the target bone by manually reciprocating the elongate body axially along the path while a portion of the guidewire remains within the body; and

wherein coupling the proximal end of the guidewire comprises coupling the proximal end of the guidewire to a tapered distal end region of the tissue modification device.

2. The method of claim 1, wherein the target bone comprises spine.

3. The method of claim 1, wherein the target bone comprises hip.

4. The method of claim 1, wherein the target bone comprises bone of a sacro-iliac joint.

5. The method of claim 1, wherein urging comprises reciprocally applying pulling force at or near opposite ends of the elongate body.

6. The method of claim 1, further comprising reciprocating the elongate body to remove a portion of the target bone.

7. The method of claim 1, wherein pulling the tissue modification device comprises advancing the elongate body percutaneously into the patient by pulling the device behind the guidewire.

8. The method of claim 1, further comprising inhibiting damage to a non-target tissue with an atraumatic surface of the elongate body configured to contact the non-target tissue when the blades contact target tissue.

9. The method of claim 1, wherein urging the active region comprises reciprocating the elongate body axially along the path by alternately applying a manual pulling force to a handle at a distal end of the guidewire and applying a manual pulling force to a handle a proximal end of the tissue modification device.

10. The method of claim 1, wherein urging the active region comprises reciprocating the elongate body axially along the path by alternately applying a manual pulling force to a handle at a distal end of the guidewire and applying a manual pulling force to a handle a proximal end of the tissue modification device, wherein the distal handle and the proximal handle move in opposite directions relative to the outside of the patient'"'"'s body such that one handle moves toward the body while the other handle moves away from the body.

11. The method of claim 1, wherein the tissue-modifying active region of the tissue modification device comprises a plurality of blades.

12. The method of claim 1, wherein the tissue-modifying active region of the tissue modification device comprises an abrasive surface.

13. The method of claim 1, wherein urging the active region of the tissue modification device against the target bone comprises abrading the target bone.

14. A method for modifying a target bone of a bone joint in a patient, the method comprising:

advancing a guidewire into the body and adjacent to the target bone so that the proximal end of the guidewire extends from a first position outside of the patient'"'"'s body and the distal end of the guidewire extends from a second position outside of the patient;

coupling the proximal end of the guidewire to a tissue modification device outside of the body after advancing the guidewire into the body, wherein the tissue modification device is for modifying bone and comprises an elongate flexible body having a tissue modifying active region at or near a distal end of the tissue modification device;

pulling the tissue modification device into the bone joint behind the guidewire to position the active region adjacent the target bone, wherein the proximal end of the guidewire remains within the body;

abrading the target bone by alternately pulling on the proximal end of the tissue modification device and the guidewire to manually reciprocate and urge the active region against the bone while the proximal end of the guidewire remains within the body; and

wherein coupling the proximal end of the guidewire comprises coupling the proximal end of the guidewire to a tapered distal end region of the tissue modification device.

15. The method of claim 14, wherein the target bone comprises spine.

16. The method of claim 14, wherein the target bone comprises hip.

17. The method of claim 14, wherein the target bone comprises bone of a sacro-iliac joint.

18. The method of claim 14, wherein pulling the tissue modification device comprises advancing the elongate body percutaneously into the patient by pulling the device behind the guidewire.

19. The method of claim 14, further comprising inhibiting damage to a non-target tissue with an atraumatic surface of the elongate body configured to contact the non-target tissue when the blades contact target tissue.

20. The method of claim 14, wherein abrading the target bone comprises reciprocating the elongate body axially by alternately applying a manual pulling force to a handle at a distal end of the guidewire and applying a manual pulling force to a handle a proximal end of the tissue modification device.

21. The method of claim 14, wherein the active region of the tissue modification device comprises a plurality of blades.

22. The method of claim 14, wherein the active region of the tissue modification device comprises an abrasive surface.